“While we might expect our bodies and brains to follow a shared trajectory of development and degeneration over time, by actively practicing strategies such as meditation, we might actually preserve and protect our physical body and brain structure to extend our golden years and shine even more brightly in old age.” – Sonima Wellness

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our mental abilities (cognition) which decline with age including impairments in memory, attention, and problem solving ability. It is inevitable and cannot be avoided. An encouraging new development is that mindfulness practices such as meditation training can significantly reduce these declines in cognitive ability. In addition, it has been found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners.

Most studies of age-related decline are cross-sectional, comparing groups of different ages. In today’s Research News article “Cognitive Aging and Long-Term Maintenance of Attentional Improvements Following Meditation Training.” (See summary below or view the full text of the study at: https://link.springer.com/article/10.1007/s41465-018-0068-1 ), Zanesco and colleagues perform a longitudinal analysis, following participants for up to 7 years to investigate the effects of a meditation retreat on cognitive ability.

They recruited experienced meditators and randomly assigned them to either a wait-list control condition or to receive a 3-month intensive meditation retreat. After completion of the first retreat, the wait-list control participants received the 3-month meditation retreat. All participants were measured before, during, and after the retreat and 6 months, and 1.5 and 7 years later with a response inhibition task. In this task, participants were asked to respond when a long line is present and not respond when an infrequent short line was presented. This task measures high level thinking including attention, response inhibition, discrimination, and vigilance.

They found that during and following the retreat there were large significant improvements in perceptual discrimination, response inhibition, vigilance, and response time variance as measured in the response inhibition task. Importantly, these improvements were maintained for as much as 7 years after the completion of the retreat. Overall, older participants had age-related declines in accuracy. But, older participants who reported large amounts of continued meditation practice, did not have declines.

This study documents that the effects of a 3-month intensive meditation retreat on cognitive ability are large and lasting. In addition, they demonstrate that age-related declines in cognitive performance can be prevented by continued meditation practice. In this study, these effects were observed longitudinally, in the same individuals over time, supplementing the previous findings with cross-sectional studies of groups of individuals of different ages. This suggests that the loss of high-level thought ability does not necessarily inevitably have to decline as we age. It can be improved and sustained with meditation practice.

“What we do know is that long-term engagement in mindfulness meditation may enhance cognitive performance in older adults, and that with persistent practice, these benefits may be sustained. That’s great news for the millions of aging adults working to combat the negative effects of aging on the brain.” – B. grace Bullock

Sustained attention is effortful, demanding, and subject to limitations associated with age-related cognitive decline. Researchers have sought to examine whether attentional capacities can be enhanced through directed mental training, with a number of studies now offering evidence that meditation practice may facilitate generalized improvements in this domain. However, the extent to which attentional gains are maintained following periods of dedicated meditation training and how such improvements are moderated by processes of aging have yet to be characterized. In a prior report (Sahdra et al., Emotion 11, 299–312, 2011), we examined attentional performance on a sustained response inhibition task before, during, and after 3-months of full-time meditation. We now extend this prior investigation across additional follow-up assessments occurring up to 7 years after the conclusion of training. Performance improvements observed during periods of intensive practice were partially maintained several years later. Importantly, aging-related decrements in measures of response inhibition accuracy and reaction time variability were moderated by levels of continued meditation practice across the follow-up period. The present study is the first to offer evidence that intensive and continued meditation practice is associated with enduring improvements in sustained attention and response inhibition, with the potential to alter longitudinal trajectories of cognitive change across the lifespan.

“As a therapist who works primarily with people with diabetes, I have found that those who have a deeper understanding of themselves and have the ability to cope well with stressful life events simply live better with diabetes, both in terms of diabetes control and general quality of life.” – Joseph Nelson

Diabetes is a major health issue. It is estimated that 30 million people in the United States and nearly 600 million people worldwide have diabetes and the numbers are growing. Diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Unlike Type I Diabetes, Type II does not require insulin injections. Instead, the treatment and prevention of Type 2 Diabetes focuses on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. There is a need for further research into this promising approach to the treatment of patients with diabetes.

In today’s Research News article “Mind–Body Interactions and Mindfulness Meditation in Diabetes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954593/ ), Priya and Kalra review and summarize the published research literature on the effectiveness of meditation-based practices for patients with diabetes. They report that the research found that meditation produces changes to the brain areas that reduce the physiological and psychological responses to stress and this improves emotion regulation and coping responses to the disease and overall feelings of well-being.

They report that in diabetes patients, meditation-based treatments have been found to improve the psychological state of the patients including improved mood and reduced psychological distress, anxiety, and depression and increased self-care behaviors. These treatments also appear to improve the diabetes patient’s physiological state including lower weight and waist circumference, improved glycemic control, and improved cardiovascular health, including blood pressure, heart rate variability, and vascular resistance.

Hence, the published research indicates that meditation-based practices are safe and effective treatments for diabetes patients. “To summarise, mindfulness interventions have demonstrated impact on a broad range of outcomes relating to all domains of holistic care in diabetes – biological, psychological and also social” (Priya and Kalra, 2018).

So, improve diabetes with meditation.

“Exercise trains the body and meditation train the mind. Many people with diabetes find meditation is a good way to reduce stress, lower blood sugar levels, lower blood pressure readings and minimize pain. Regular meditation should become an important part of your diabetes self-management program.” – Roberta Kleinman

Diabetes is associated with significant psychological distress. It is, therefore, important to ensure the physical and emotional as well as psychosocial wellbeing of individuals living with diabetes. Meditation-based strategies have been evaluated for their complementary role in several chronic disorders including depression, anxiety, obesity, hypertension, cardiovascular disease and diabetes. The practice of meditation is associated with reduction in stress and negative emotions and improvements in patient attitude, health-related behaviour and coping skills. There is increased parasympathetic activity with reduction in sympathetic vascular tone, stress hormones and inflammatory markers. Additionally, several studies evaluated the role of mindfulness-based stress reduction in diabetic individuals and demonstrated modest improvements in body weight, glycaemic control and blood pressure. Thus, mindfulness meditation-based intervention can lead to improvements across all domains of holistic care – biological, psychological and social. Though most of these studies have been of short duration and included small numbers of patients, meditation strategies can be useful adjunctive techniques to lifestyle modification and pharmacological management of diabetes and help improve patient wellbeing.

“it’s clear that mindfulness allows us to interrupt automatic, reflexive fight, flight, or freeze reactions—reactions that can lead to anxiety, fear, foreboding, and worry.” – Bob Stahl

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. This may indicate that treating the cognitive processes that underlie the anxiety may be an effective treatment. Indeed, Mindfulness practices have been shown to be quite effective in relieving anxiety.

Anxiety disorders have generally been treated with drugs. But, there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders. Mindfulness-Based Cognitive Therapy (MBCT) was developed to treat depression but has been found to also be effective for other mood disorders. MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate mood disorders. MBCT has been found to help relieve anxiety.

Although the ability of Mindfulness-Based Cognitive Therapy (MBCT) to relieve anxiety is well established in western populations, there is less research employing oriental populations. In today’s Research News article “Feasibility study of mindfulness-based cognitive therapy for anxiety disorders in a Japanese setting.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127937/ ), Sado and colleagues recruited Japanese participants who were diagnosed with either panic disorder, social anxiety disorder, obsessive compulsive disorder, or generalized anxiety disorder. They were provided with an 8-week program of MBCT. The participants met in groups for 2 hours, once a week, and were asked to practice at home. They were measured before, during, and after training and 4 and 8 weeks later for mindfulness, anxiety, depression, psychological distress, health status, quality of life, agoraphobia, and social anxiety disorder.

They found that after treatment there were significant increases in mindfulness and decreases in anxiety and agoraphobia that were maintained 8 weeks after the end of treatment. There was also a significant improvement in psychological distress after treatment, but this was not maintained at follow-up. These results are similar to those observed in western populations. So, it appears that MBCT is similarly effective in eastern (Japanese) anxiety disorder sufferers. This suggests that MBCT is a safe and effective treatment for anxiety disorders in a wide range of patients, races, and cultures.

So, improve anxiety disorders with mindfulness.

“A review of 47 studies showed a 5 percent to 10 percent reduction in anxiety symptoms and a 10 percent to 20 percent improvement in depression in individuals who meditated.” – Nicole Ostrow

Mindfulness-based cognitive therapy (MBCT) could be a treatment option for anxiety disorders. Although its effectiveness under conditions of low pharmacotherapy rates has been demonstrated, its effectiveness under condition of high pharmacotherapy rate is still unknown. The aim of the study was to evaluate effectiveness of MBCT under the context of high pharmacotherapy rates.

Results

A single arm with pre-post comparison design was adopted. Those who had any diagnosis of anxiety disorders, between the ages of 20 and 74, were included. Participants attended 8 weekly 2-hour-long sessions followed by 2 monthly boosters. Evaluation was conducted at baseline, in the middle, at end of the intervention, and at follow-up. The State-Trait Anxiety Inventory (STAI)-state was set as the primary outcome. Pre-post analyses with mixed-effect models repeated measures were conducted. Fourteen patients were involved. The mean age was 45.0, and 71.4% were female. The mean change in the STAI-state at every point showed statistically significant improvement. The STAI-trait also showed improvement at a high significance level from the very early stages. The participants showed significant improvement at least one point in some other secondary outcomes.

Improve the Well-Being of Dementia Patients and Their Caregivers with Mindfulness

By John M. de Castro, Ph.D.

“people who care for family members with Alzheimer’s disease and other dementias in the home experienced a decrease in perceived stress and mood disturbance when practicing Mindfulness-based Stress Reduction (MBSR). Another trial indicates that MBSR was “more effective at improving overall mental health, reducing stress, and decreasing depression” than those who only participated in a caregiver education and support intervention.” – Heather Stang

Dementia is a progressive loss of mental function produced by degenerative diseases of the brain. Dementia patients require caregiving particularly in the later stages of the disease. Caregiving for dementia patients is a daunting intense experience that can go on for four to eight years with increasing responsibilities as the loved one deteriorates. This places tremendous psychological and financial stress on the caregiver. Hence, there is a need to both care for the dementia patients and also for the caregivers. Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving. In addition, mindfulness training has been found to help protect aging individuals from physical and cognitive declines.

In today’s Research News article “Mindfulness Training for People With Dementia and Their Caregivers: Rationale, Current Research, and Future Directions.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008507/ ), Berk and colleagues review and summarize the published research literature on the effectiveness of mindfulness training for both the patients with dementia and their caregivers.

They found that the literature reports that mindfulness training can help patients with mild cognitive decline by improving memory. They also report that mindfulness training improves the quality of life and depression in dementia patients and their caregivers when they are trained in mindfulness together. They further found that the research reports that mindfulness training helps the caregivers for the dementia patient by lowering perceived stress levels and depression and improving their quality of life. Hence, it appears that mindfulness training improves the well-being of both dementia patients and their caregivers.

These results fit with previous findings that mindfulness training in general improves the psychological and physiological responses to stress, depression, cognitive function, and quality of life in a wide variety of patients and healthy individuals of all ages. The results further suggests that training the dementia patient and their caregiver together is feasible and may have additional benefits for both.

So, improve the well-being of dementia patients and their caregivers with mindfulness.

“The disease is challenging for the affected person, family members, and caregivers. Although they know things will likely get worse, they can learn to focus on the present, deriving enjoyment in the moment with acceptance and without excessive worry about the future. This is what was taught in the mindfulness program.” – Ken Paller

The world population is aging and the prevalence of dementia is increasing. By 2050, those aged 60 years and older are expected to make up a quarter of the population. With that, the number of people with dementia is increasing. Unfortunately, there is no cure for dementia. The progression of symptoms with no hope of improvement is difficult to cope with, both for patients and their caregivers. New and evidence-based strategies are needed to support the well-being of both caregiver and patient. Mindfulness training is a body-mind intervention that has shown to improve psychological well-being in a variety of mental health conditions. Mindfulness, a non-judgmental attention to one’s experience in the present moment, is a skill that can be developed with a standard 8-week training. Research has shown preliminary but promising results for mindfulness-based interventions to benefit people with dementia and caregivers. The aim of this review is (a) to provide a rationale for the application of mindfulness in the context of dementia care by giving an overview of studies on mindfulness for people with dementia and/or their caregivers and (b) to provide suggestions for future projects on mindfulness in the context of dementia and to give recommendations for future research.

Improve Tolerance of Distress and Psychological State with Mindfulness

By John M. de Castro, Ph.D.

“Distress Tolerance skills are used to help us cope and survive during a crisis, and helps us tolerate short term or long term pain (physical or emotional). Tolerating distress includes a mindfulness of breathand mindful awareness of situations and ourselves.” – DBT Self Help

Psychological distress is related to an increase in physiological stress responses. That is, when the individual is anxious, ruminating, or having negative emotions, the physiology including the hormonal system reacts. The increased activity can be measured in heightened stress hormones in the blood and increased heart rate, blood pressure etc. These physiological stress responses on the short-term are adaptive and help to fight off infection, toxins, injury, etc. Unfortunately, psychological distress is often persistent and chronic and resulting in chronic stress which in turn can produce disease.

Many of the symptoms of psychological distress have been shown to be related to a lack of mindfulness. Anxiety is often rooted in a persistent dread of future negative events while rumination is rooted in the past, with persistent replaying of negative past events. Since mindfulness is firmly rooted in the present it is antagonistic toward anything rooted in the past or future. Hence, high levels of mindfulness cannot coexist with anxiety and rumination. In addition, high mindfulness has been shown to be related to high levels of emotion regulation and positive emotions. So, mindfulness would appear to be an antidote to psychological distress.

In today’s Research News article “Dimensions of distress tolerance and the moderating effects on mindfulness-based stress reduction.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6130202/ ), Gawrysiak and colleagues recruited participants in an 8-week Mindfulness-Based Stress Reduction (MBSR) program. The program was specifically developed to improve coping with stress and consisted of weekly 2.5-hour group training sessions with home practice and included meditation, body scan, yoga practices, and discussion. They were measured before and after training for distress tolerance, perceived stress, and positive and negative emotions.

They found that following the MBSR program the participants demonstrated significant increases in distress tolerance and vigor and decreases in perceived stress, anger, confusion, depression, fatigue, and tension. In addition, they found that participants who were low in distress tolerance had the greatest decreases in perceived stress after the program while those high in distress tolerance had the least change.

Hence, they found that the MBSR program improved the psychological state in the participants. This is in line with previous research that demonstrated that mindfulness training improves psychological and physiological responses to stress and improves emotions. What this study contributes is the understanding that MBSR improves that participants ability to cope with psychological distress. Importantly, they also found that the participants who benefited the most were the ones who had the least ability to cope with distress to begin with. This suggests that one of the reasons that MBSR training is beneficial is that it improves the individuals ability to deal effectively with tough emotions and situations which, in turn, improves the individuals ability to deal effectively with stress. This, then, improves their emotional state.

So, improve tolerance of distress and psychological state with mindfulness.

“Mindfulness helps you go home to the present. And every time you go there and recognize a condition of happiness that you have, happiness comes.” — Thich Nhat Hanh

This study examined the relationship between distress tolerance and psychosocial changes among individuals participating in Mindfulness-Based Stress Reduction (MBSR). The objective of the analysis was to discern whether individuals with lower distress tolerance measured before MBSR showed larger reductions in perceived stress following MBSR.

Design and Methods:

Data were collected from a sample of convenience (n = 372) using a quasi-experimental design. Participants completed self-report measures immediately prior to course enrollment and following course completion.

The finding that individuals with lower baseline distress tolerance evidenced a greater decline in perceived stress may offer hints about who is most likely to benefit from MBSR and other mindfulness-based treatments. Identifying moderators of treatment outcomes may yield important benefits in matching individuals to treatments that are most likely to work for them.

Mindfulness Promotes Health and Well-Being in Stressed College Students

By John M. de Castro, Ph.D.

“Student life can be stressful, but that doesn’t mean students have to let stress take over their lives. By incorporating mindfulness and meditation into daily routines, students can not only relieve the pressure, but also improve their memory, focus and ultimately their grades.“ – Todd Braver

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on students to excel so that they can be admitted to the best universities and there is a lot of pressure on university students to excel so that they can get the best jobs after graduation. This is particularly true in highly rated, elite, universities. This stress might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance.

In today’s Research News article “There Is No Performance, There Is Just This Moment: The Role of Mindfulness Instruction in Promoting Health and Well-Being Among Students at a Highly-Ranked University in the United States.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871302/ ), Kerrigan and colleagues recruited college students from an elite university and provided them with an 8-week Mindfulness-Based Stress Reduction (MBSR) program. The program was specifically developed to improve coping with stress and consisted of weekly 2.5-hour group training sessions with home practice and included meditation, body scan, yoga practices, and discussion. They were interviewed before and after training on “personal goals, priorities, and background; current and past stressors and coping strategies; motivations to participate in the program; experiences with the program; barriers to attendance and practice of program techniques; and impact and future use of the MBSR tools and methods.”

The students described the high pressure, stressful, competitive environment of the university, their challenging schedules of academic studies, extracurricular activities, and volunteer work, and family pressure to succeed. About half of the participants reported chronic health conditions as a result of the stress. Reducing this stress was their primary motivation for participating in the MBSR program. They described the MBSR program as cultivating mindfulness, attention to the present moment and non-judgement. Non-judgement was particularly important as it stood in stark contrast to the competitive environment of the university. They also indicated that the program allowed them to step back and reframe their current existence and their lives. They described the benefits that they obtained from the MBSR program of reducing stress and anxiety and improving coping skills. They also reported improved relationships and academic performance.

These qualitative results suggest that participation in Mindfulness-Based Stress Reduction (MBSR) program was of great benefit to these stressed college students, reducing their responses to stress and their self-judgement, and improving their mindfulness, productivity and overall well-being. These results mirror those seen with controlled quantitative studies. This suggests that participation in an MBSR program should be recommended for college students.

So, promote health and well-being in stressed college students with mindfulness.

“a mindfulness intervention can help reduce distress levels in college students during a stressful exam week, as well as increase altruistic action in the form of donating to charity.” – Julia Galante

Kerrigan, D., Chau, V., King, M., Holman, E., Joffe, A., & Sibinga, E. (2017). There Is No Performance, There Is Just This Moment: The Role of Mindfulness Instruction in Promoting Health and Well-Being Among Students at a Highly-Ranked University in the United States. Journal of Evidence-Based Complementary & Alternative Medicine, 22(4), 909–918. http://doi.org/10.1177/2156587217719787

Abstract

Mindfulness-based stress reduction (MBSR) has been shown to improve health outcomes across populations. We explored the feasibility, acceptability, and initial effects of a pilot MBSR program at a highly-ranked university in the United States. We conducted 23 in-depth interviews with 13 students. Interviews explored stressors and coping mechanisms, experiences with MBSR, and its reported impact and potential future use. Interviews were analyzed using thematic content and narrative analyses. Results indicated that students are exposed to a very high level of constant stress related to the sheer amount of work and activities that they have and the pervasive surrounding university culture of perfectionism. MBSR offered an opportunity to step back and gain perspective on issues of balance and priorities and provided concrete techniques to counter the effects of stressors. We conclude that MBSR and mindfulness programs may contribute to more supportive university learning environments and greater health and well-being among students.

“The science of Tai Chi is just now catching up with and substantiating what Tai Chi practitioners have known for centuries – Tai Chi often leads to more vigor and energy, greater flexibility, balance and mobility, and an improved sense of well-being. Cutting-edge research now lends support to long-standing claims that Tai Chi favorably impacts the health of the heart, bones, nerves and muscles, immune system, and the mind.” – Peter Wayne

Self-efficacy is the belief in one’s ability to succeed in specific situations or accomplish a task. It is an important characteristic for the individual’s ability to effectively navigate the complex and stressful environments in the modern world. It is an important foundation for success in many areas of life. So, methods that could help to improve the development of self-efficacy may be very helpful for the individual throughout the course of their life. A relatively simple method to do this is Mindfulness training. Indeed, it has been shown to significantly improve self-efficacy.

Tai Chi is gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice would appear to be an almost ideal gentle mindfulness training and light exercise to improve psychological health and well-being and perhaps self-efficacy.

In today’s Research News article “Effects of Tai Chi on Self-Efficacy: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6114250/ ), Tong and colleagues reviewed and summarized the published research literature on the effectiveness of Tai Chi practice to improve self-efficacy. Their review of the literature revealed 27 studies, 20 of which were randomized controlled trials.

They report that the vast majority of the studies found that engaging in Tai Chi practice produced significant improvement in self-efficacy. This was true for college students and the elderly and for patients with diseases including arthritis, heart failure, Chronic Obstructive Pulmonary Disease (COPD), and other diseases. Unfortunately, although significant improvement were observed relative to baseline, many of the studies were of low quality or involved small numbers of participants resulting in a lack of significant differences compared to control groups.

Obviously, more research is needed employing stronger research designs and larger numbers of participants. But, the existing published research suggests that Tai Chi practice is a safe and effective method to improve self-efficacy in a wide range of people with or without diseases. Hence, this simple, inexpensive, convenient, safe, and fun practice may improve the participants ability to successfully conduct their lives, improving health and well-being.

So, increase self-efficacy with Tai Chi.

“In the search for effective ways to experience positive outcomes in the all-important life aspects such as overall health, well-being and mortality, one of the sleeper strategies to consider involves adopting an ancient Chinese practice called tai chi.” – Suzanne Kane

The purpose of this systematic review is to summarize and update the readers regarding clinical studies that have investigated the effects of Tai Chi on self-efficacy and to describe their limitations and biases. Nine electronic databases were searched from the establishment of the database until August 10, 2017. All randomized controlled trials (RCTs), nonrandomized controlled studies (NRSs), quasi-experimental studies, or studies with pre-post design were included if they clearly defined a Tai Chi intervention and evaluated self-efficacy outcomes. We categorized these 27 studies into the “disease category” and the “population category,” based on the types of participants. This systematic review summarizes the effects of Tai Chi on self-efficacy in various populations and found that Tai Chi appeared to have positive effects on self-efficacy in some populations. Fifteen research studies showed that Tai Chi had significant positive effects on self-efficacy, while 11 studies did not; only one study found a negative outcome at the follow-up. In addition, it is unclear which type, frequency, and duration of Tai Chi intervention most effectively enhanced self-efficacy. Tai Chi appears to be associated with improvements in self-efficacy. Definitive conclusions were limited due to the variation in study designs, type of Tai Chi intervention, and frequency, and further high-quality studies are required.

“Yoga is designed to bring about increased physical, mental and emotional well-being. Hand in hand with leading a heart-healthy lifestyle, it really is possible for a yoga-based model to help prevent or reverse heart disease. It may not completely reverse it, but you will definitely see benefits.” – M. Mala Cunningham

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” (Centers for Disease Control). A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Cardiac rehabilitation programs for patients recovering from a heart failure, emphasize these lifestyle changes. Unfortunately, for a variety of reasons, 60% of heart failure patients decline participation, making these patients at high risk for another attack.

In today’s Research News article “Yoga as an Alternative and Complimentary Therapy for Cardiovascular Disease: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871178/ ), Haider and colleagues reviewed and summarized the published research literature on the effects of yoga practice on risk factors for cardiovascular disease.

They found 12 published studies, 7 of which were randomized controlled trials. There were large differences in the methodology, duration of practice, and measures employed in these studies. Nevertheless all 12 studies reported significant improvements in at least one cardiovascular disease risk factor. These included “both physical and mental factors, including body mass index, blood pressure, cholesterol, anxiety, depression, quality of life, weight, and pulmonary function.” Hence, the published research literature suggests that yoga practice is a safe and effective treatment that can reduce risk factors for cardiovascular disease.

So, decrease cardiovascular disease risk with yoga.

“A large number of studies show that yoga benefits many aspects of cardiovascular health. There’s been a major shift in the last five years or so in the number of cardiologists and other professionals recognizing that these benefits are real.” – Hugh Calkins

Cardiovascular disease is a leading cause of disability and death worldwide. Yoga, a mind-body exercise, utilizes breathing techniques with low-impact physical activity that may be an alternative treatment for cardiovascular disease. The purpose of this systematic review was to examine yoga interventions for patients at-risk for and/or suffering from cardiovascular disease. The inclusion criteria for interventions were (a) published in the English language between 2005 and 2015; (b) indexed in MEDLINE/PubMed, CINAHL, or Alt HealthWatch; (c) employed a quantitative design; and (d) applied a yoga intervention. Twelve interventions met the inclusion criteria, of which, all documented significant improvements in one or more factors associated with cardiovascular disease. Limitations to the studies in this review included a lack of studies adhering to the inclusion criteria, small sample sizes, and high attrition rates. Despite the limitations, this review demonstrates the clear potential yoga has as an alternative and complementary means to improve cardiovascular disease risk.

“So many people who want and would benefit from mindfulness meditation training do not ever receive it because of schedules, location, and / or an aversion to being in live groups. Offering mindfulness training in an Internet format allows these people to actually receive the training benefits. We are lucky to live in a world where such alternative formats are available.” – Helané Wahbeh

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. They have been shown to be very helpful in treating anxiety and depression. The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient.

As an alternative, mindfulness training programs have been developed to be implemented over the internet. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But, the question arises as to the effectiveness of these programs in inducing mindfulness and improving the treatment of anxiety and depression. In today’s Research News article “). Online mindfulness-enhanced cognitive behavioural therapy for anxiety and depression: Outcomes of a pilot trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6112099/ ), Kladnitski and colleagues addressed this issue.

They recruited participants through social media who were diagnosed with either generalized anxiety disorder, social phobia, panic disorder, agoraphobia, obsessive compulsive disorder, and/or major depressive disorder. They completed a 7-week online program of cognitive behavioral therapy (CBT) with mindfulness training. CBT that is designed to address and change maladaptive thought patterns that lead to psychological problems and includes behavioral activation, cognitive restructuring, and graded exposure. They added online mindfulness training also to the program. The entire program was similar to the Mindfulness-Based Cognitive Therapy (MBCT) program. The participants were measured online before, during, and after the 7-week program and 3 months later for psychiatric symptoms, psychiatric distress, depression, anxiety, mental well-being, disability, worry, rumination, experiential avoidance, emotion regulation, and mindfulness.

They found that engagement in the program was low with only 59% of the original participants completing the 7-week program. All of the measures showed significant improvements with moderate to large effect sizes after training compared to baseline and these improvements persisted 3 months later. So, the 7-week online program or cognitive behavioral therapy (CBT) with mindfulness training reduced the psychological pain and improved the psychological well-being of adults with anxiety or depressive disorders.

These results need to be interpreted with caution because of the high drop out rates. The individuals who were not being helped or even harmed by the program may have dropped out leaving only those participants who were improving. Future work needs to improve retention rates for the treatment to be seen as useful. Also, the lack of an active control condition opens the study up to a large array of potential confounds.

But, it has been well established in a number of well controlled studies that mindfulness improves the symptoms and mental well being of patients with anxiety and depression. The present study simply demonstrates that presentation of the treatment online is similarly effective. By being able to provide the treatment online it greatly reduces costs, makes the treatment more widely available even to remote locations, and makes it convenient for the patients. That is why it is so important to establish its effectiveness of the online program in relieving the suffering of anxiety and depression patients.

Transdiagnostic internet-delivered cognitive behavioural therapies (iCBT) are effective for treating anxiety and depression, but there is room for improvement. In this study we developed a new Mindfulness-Enhanced iCBT intervention by incorporating formal and informal mindfulness exercises within an existing transdiagnostic iCBT program for mixed depression and anxiety. We examined the acceptability, feasibility, and outcomes of this new program in a sample of 22 adults with anxiety disorders and/or major depression. Participants took part in the 7-lesson clinician-guided online intervention over 14 weeks, and completed measures of distress (K-10), anxiety (GAD-7), depression (PHQ-9), mindfulness (FFMQ) and well-being (WEMBWS) at pre-, mid-, post-treatment, and three months post-treatment. Treatment engagement, satisfaction, and side-effects were assessed. We found large, significant reductions in distress (Hedges g = 1.55), anxiety (g = 1.39), and depression (g = 1.96), and improvements in trait mindfulness (g = 0.98) and well-being (g = 1.26) between baseline and post-treatment, all of which were maintained at follow-up. Treatment satisfaction was high for treatment-completers, with minimal side-effects reported, although adherence was lower than expected (59.1% completed). These findings show that it is feasible to integrate online mindfulness training with iCBT for the treatment of anxiety and depression, but further research is needed to improve adherence. A randomised controlled trial is needed to explore the efficacy of this program.

“An average course student practices 30 minutes daily at home, but the good news is that nevertheless, this practice is related to positive benefit. This can be measured as reduced stress, pain, better well-being and so on.” – Science Daily

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

With impacts so great it is important to know how to optimize the development of mindfulness. Most forms of training require or strongly suggest that the participants practice at home. It is not established, however, how important this home practice is to the beneficial outcomes of mindfulness practice. In today’s Research News article “The Utility of Home-Practice in Mindfulness-Based Group Interventions: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968057/ ), Lloyd and colleagues reviewed and summarized the published research literature on the benefits of home practice in association with Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT).

They found 14 controlled studies, 8 of which employed MBSR and 6 employed MBCT treating a total of 725 participants. All of these studies used self-report measures of home practice that varied considerably in technique and variables measured. MBSR and MBCT trainings require home practice of 45 minutes per day for 6 days a week (270 minutes). They report that the studies found that actual home practice varied considerably from study to study ranging from 15% to 88% of the recommended amount. The results reported on the impact of home practice on clinical and non-clinical outcome measures were mixed partially due the wide differences in reporting techniques, analyses reported and procedures. Of the 14 reviewed studies only 7 examined the relationship between home-practice and clinical outcomes, of these 4 found that home-practice predicted small but significant improvements on clinical outcome measures.

Hence, there are indications suggesting that home practice may be useful for improving the clinical outcomes of mindfulness training. But, the research is so widely different that it is impossible to reach firm conclusions. There is a great need for more attention to the topic employing more standardized assessment techniques. It is important to establish what are the necessary components of practice to produce benefits. The reviewed studies suggest that home practice may be beneficial. This should help in the future in better delineating and refining the most beneficial training techniques.

So, improve mindfulness treatment outcomes with home practice.

“mindfulness home practice may have a small but positive effect on treatment outcomes, however the strength of this association was not found to depend on the length of time people spent practicing.” – Elena Marcus

A growing body of research supports the efficacy of mindfulness-based interventions (MBIs). MBIs consider home-practice as essential to increasing the therapeutic effects of the treatment. To date however, the synthesis of the research conducted on the role of home-practice in controlled MBI studies has been a neglected area. This review aimed to conduct a narrative synthesis of published controlled studies, evaluating mindfulness-based group interventions, which have specifically measured home-practice. Empirical research literature published until June 2016 was searched using five databases. The search strategy focused on mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and home-practice. Included studies met the following criteria: controlled trials, participants 18 years and above, evaluations of MBSR or MBCT, utilised standardised quantitative outcome measures and monitored home-practice using a self-reported measure. Fourteen studies met the criteria and were included in the review. Across all studies, there was heterogeneity in the guidance and resources provided to participants and the approaches used for monitoring home-practice. In addition, the guidance on the length of home-practice was variable across studies, which indicates that research studies and teachers are not adhering to the published protocols. Finally, only seven studies examined the relationship between home-practice and clinical outcomes, of which four found that home-practice predicted improvements on clinical outcome measures. Future research should adopt a standardised approach for monitoring home-practice across MBIs. Additionally, studies should assess whether the amount of home-practice recommended to participants is in line with MBSR/MBCT manualised protocols. Finally, research should utilise experimental methodologies to explicitly explore the relationship between home-practice and clinical outcomes.